This article is part of the supplement: Proceedings of the 13th International Conference on Malignancies in AIDS and Other Acquired Immunodeficiencies (ICMAOI)

Open Access Poster presentation

Digital cervicography and cold coagulation for cervical cancer screening in Nigeria

Clement Adebamowo1,2*, Maryam Almujtaba1, Zahra Modibbo1, Olayinka Olaniyan3 and William Blattner1

Author Affiliations

1 Office of Strategic Information, Research and Training, Institute of Human Virology, Abuja, Nigeria

2 Department of Epidemiology, Institute of Human Virology, University of Maryland School of Medicine, Baltimore, MD, USA

3 National Hospital, Abuja, Nigeria

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Infectious Agents and Cancer 2012, 7(Suppl 1):P14 doi:10.1186/1750-9378-7-S1-P14


The electronic version of this article is the complete one and can be found online at: http://www.infectagentscancer.com/content/7/S1/P14


Published:19 April 2012

© 2012 Adebamowo et al; licensee BioMed Central Ltd.

Background

Cervical cancer (CC) is most common cancer among women in Africa and in women living with HIV [1,2]. Its prevalence has remained stable or increasing with introduction of HAART suggesting complex interactions with HIV [3,4]. Current screening programs can substantially reduce all-cause mortality of CC but implementation in LMIC is hobbled by poor infrastructure, cost and lack of personnel. Nurse provider led, minimal visit, screen and treat programs offer an opportunity to reduce CC morbidity and mortality in LMIC [5]. In this study we evaluate the implementation of cervical cancer screen and treat programs at 2 HIV treatment and prevention sites in Nigeria.

Material and methods

CC screening programs using nurse providers, VIA, off the shelf camera for digital cervicography, treatment of eligible lesions by cold coagulation and referral as required was implemented at 2 PEPFAR supported sites in Abuja, Central Nigeria. QA was provided by Gynecologist and based on weekly review of digital cervicographs and client recall as required.

Results

From July 2010 to July 2011, 2002 HIV+ women had been screened for CC at the 2 sites, but only data on 925 is reported in this abstract. Mean (SD) age was 35.2 (7.0) years; mean (sd) age at sexual debut was 19.0 (3.9) years; range, mean, sd of pregnancies was 0 – 16, 3.4, 2.5; range, mean, sd of pregnancies was 0 – 12, 1.6, 1.8; range, mean, sd of most recent cd4 count before screening was 11 – 1197, 466.7, 239.0; 6.8% were VIA positive; 0.2% had invasive CC and 0.2% were uncertain. Concordance between the clinical review and nursing diagnosis was 65% at the beginning of the program but reached 100% after 3 months.

Conclusions

This study showed nurse provider led CC screening and treatment program is a viable public health intervention among PLWHIV in Nigeria.

Acknowledgement

This study is supported by the IHV-UM Capacity Development for Research into AIDS Associated Malignancies (NIH/NCI D43CA153792-01 PI, Adebamowo) and IHV-UM AIDS International Training and Research Program (NIH/FIC D43TW001041-11 PI, Blattner).

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